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General NPI Number Information
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NPI Number | 1962832717
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Entity Type | Organization
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Legal Business Name | WESTSIDE GENERAL PRACTICE ASSOCIATES LTD
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Dates
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Enumeration Date | 11/14/2013
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Last Update Date | 11/14/2013
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Provider Practice Location Address
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Address Line | 6528 W INDIAN SCHOOL RD
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City | PHOENIX
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State | AZ
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Zip | 85033-3329
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Country | US
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Telephone | 623-846-3186
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Fax | 623-846-3757
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Provider Business Mailing Address
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Address Line | 6528 W INDIAN SCHOOL RD
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City | PHOENIX
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State | AZ
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Zip | 85033-3329
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Country | US
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Telephone | 623-846-3186
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Fax | 623-846-3757
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | NORMA ANAYA
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Credential |
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Telephone | 623-846-3186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 1209
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License Number State | AZ
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